摘要
目的探索一种基于虚拟现实可视化技术的颈椎弓根螺钉置钉方法。方法选取6例成人颅-颈椎标本,改进的四柱式定位框架以螺钉固定于枕颈部,使颅-颈-肩形成统一刚性结构,保持空间位置恒定。CT薄层扫描获取60个椎弓根的空间定位数据,Aero—tech手术规划系统三维建模,设计安全、个体化的置钉路径,导向弓把持下经皮细钻钻孔,套管针导引下置入攻丝,复查CT评价置钉的准确性。结果60个椎弓根置钉中,攻丝与规划路径有偏差者8个,失败率为13%,横突孔方向突破5个,椎管骨皮质突破3个;6例位于C(3-5)(占75%);2例位于C1、C2椎体(占25%)。结论框架立体定向图像引导的颈椎弓根螺钉个体化置入方向精确,减少置钉的并发症,置钉过程直观、简单,能术前虚拟演示,有临床应用前景。
Objective To investigate a new methods of individual cervical pedicle screws placement being based upon virtual reality-scientific visualization technique ( imaging being syncretlzed and intersected virtual path maneuvering and real time navigation ). Methods 6 adult cranio-cervlcal cadavers, Ameliorated four-column stereotactic frame was installed on occlpital-cervical with screws, Made craniocervical-scapular to shape uniform rigid body, Kept spaclal position stable, Thin-sllce CT scan acquired spaeial position data of 60 cervical pedlele. Aero-teeh surgical plan software assisted construction of threedimension model. Designed the safe ,individual inserting path, Guide-arch hold the accurate direction to drill percutaneously, Trocar guided inserting guidewire, CT-countercheck assessed placement veracity. Results 8 Inserting appeared divergence of guide wire and plan path ( 13% ). Breaches of transverse foramen was five, breaches of spinal canal was three. The departure located at C3 - C5 segment represented 75%. Conclusion Frame-stereotactlc image-gulded individual cervical pedlcle screws placement ensures the accurate direction, reduces surgical complication. Inserting path was simplified, intuitlonistlc and virtual maneuvering. Perspective of clinical application was better.
出处
《中华神经外科杂志》
CSCD
北大核心
2007年第4期301-304,共4页
Chinese Journal of Neurosurgery
关键词
颈椎
椎弓根螺钉
立体定位技术
框架
Cervical spine
Pedicle screws
Stereotaric techniques
Frame-stereotactic